Provider Demographics
NPI:1568151454
Name:NICKLES, ADAM (AUD)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:NICKLES
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 BEN CASEY DR STE 105
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29708-6600
Mailing Address - Country:US
Mailing Address - Phone:803-547-4327
Mailing Address - Fax:803-547-4329
Practice Address - Street 1:PALMETTO FAMILY HEARING CENTER
Practice Address - Street 2:127 BEN CASEY DR., STE. 105
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29708
Practice Address - Country:US
Practice Address - Phone:803-547-4327
Practice Address - Fax:803-547-4329
Is Sole Proprietor?:No
Enumeration Date:2023-05-05
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist